2of26Judy Kveton holds a photo of her husband, David. He died of complications from a heart transplant at Baylor St. Luke's Medical Center.Photo: Elizabeth Conley

3of26A photo of David Kveton sits on the nightstand next to his widow's bed at their home in Fort Bend County, Texas.Photo: Elizabeth Conley/Houston Chronicle

4of26About two months after David Kveton's death, his wife, Judy Kveton, received an anonymous letter stating that there were problems with David's heart transplant at Baylor St. Luke's Medical Center.Photo: Elizabeth Conley/Houston Chronicle

5of26About two months after David Kveton's death, his wife, Judy Kveton, received an anonymous letter stating there were problems with his heart transplant at Baylor St. Luke's Medical Center.Photo: Elizabeth Conley

6of26About two months after David Kveton's death, his wife, Judy Kveton, received an anonymous letter stating that there were problems with David's heart transplant at Baylor St. Luke's Medical Center.Photo: Elizabeth Conley/Houston Chronicle

7of26Brad Kveton pauses as he talks about his dad, David, who died of complications after a heart transplant at Baylor St. Luke's Medical Center.Photo: Elizabeth Conley/Houston Chronicle

8of26Judy Kveton talks about her husband, David, who died of complications from a heart transplant at Baylor St. Luke's Medical Center.Photo: Elizabeth Conley/Houston Chronicle

9of26Judy Kveton looks over bills from her husband's time in the hospital in their home in Fort Bend County, Texas.Photo: Elizabeth Conley/Houston Chronicle

10of26Lazerick Eskridge suffered severe complications after his heart transplant last year at Baylor St. Luke's Medical Center.Photo: Elizabeth Conley

12of26Roseanna McLaren looks through photo albums in her home, in Alvin. Roseanna McLaren's mother, Muta Melton, died in 2015 following a heart transplant at Baylor St. Luke's Medical Center.Photo: Elizabeth Conley

13of26Muta Melton died in 2015 after receiving a heart transplant at Baylor St. Luke's Medical Center.Photo: Elizabeth Conley

14of26Dr. Jeffrey Morgan took over as director of the heart transplant program at Baylor St. Luke's Medical Center in 2016.Photo: Elizabeth Conley

15of26Dr. Todd Rosengart is the chair of surgery at Baylor College of Medicine. He played a leading role in hiring Dr. Jeffery Morgan.Photo: St. Luke s Episcopal Hospital

16of26Dr. Hari Mallidi is the former director of the heart and lung transplant programs at Baylor St. Luke's Medical Center. He left the program in 2015.Photo: Courtesy of Texas Heart Institute

20of26Regina Tran takes a moment while reflecting on the memory of her brother, Travis Hogan, who died in 2016 after being removed from the heart transplant waiting list at Baylor St. Luke's Medical Center.Photo: Elizabeth Conley/Houston Chronicle

21of26Regina Tran holds a photo of her brother, Travis Hogan, who died in 2016 after being removed from the heart transplant waiting list at Baylor St. Luke's Medical Center.Photo: Elizabeth Conley/Houston Chronicle

22of26Regina Tran holds a photo of her brother, Travis Hogan, who died in 2016 after being removed from the heart transplant waiting list at Baylor St. Luke's Medical Center.Photo: Elizabeth Conley/Houston Chronicle

23of26Regina now collects random feathers that fall into her life in memory of her brother, Travis Hogan, who died in 2016 after being removed from the heart transplant waiting list at Baylor St. Luke's Medical Center.Photo: Elizabeth Conley/Houston Chronicle

24of26Travis Hogan died in 2016 after being removed from the heart transplant waiting list at Baylor St. Luke's Medical Center.Photo: Elizabeth Conley/Houston Chronicle

25of26A photo of Travis Hogan with his sisters on a shelf in their parents' Pasadena, Texas, home. Hogan was removed from the heart transplant list from Baylor St. Luke's Medical Center in 2016 and died a few months later.Photo: Elizabeth Conley/Houston Chronicle

26of26Regina Tran takes a moment while reflecting on the memory of her brother, Travis Hogan, who died in 2016 after being removed from the heart transplant waiting list at Baylor St. Luke's Medical Center.Photo: Elizabeth Conley/Houston Chronicle

Baylor St. Luke's Medical Center in Houston temporarily suspended its renowned heart transplant program on Friday following two deaths in recent weeks, saying it needs to reassess what went wrong and determine the path forward.

Colleagues had raised concerns to hospital leaders about the program's direction under Dr. Jeffrey Morgan, its surgical director since 2016. A second surgeon, Dr. Masahiro Ono, left for another job this week. Neither Morgan nor Ono responded to requests for comment.

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David Kveton died after a failed heart transplant at Baylor St. Luke’s Medical Center. At first, his wife thought he had just been unlucky. Then she received an anonymous letter from someone at the hospital.

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"We greatly respect and value the trust patients and their families have placed in us over the years, and believe this temporary pause will serve their best interests," Doug Lawson, CEO of Catholic Health Initiatives Texas Division, which owns St. Luke's, said in a written statement Friday afternoon. "Although extensive reviews are conducted on each unsuccessful transplant, the recent patient outcomes deserve an in-depth review before we move forward with the program. Our prayers are with the families, as well as all those on the waiting list."

For weeks, officials at St. Luke's and its affiliated Baylor College of Medicine have defended the program, saying they had made improvements after a string of patient deaths in 2015. Officials said the program's one-year survival rate after heart transplants had reached 94 percent in 2016 and 2017 under Morgan's leadership.

But of nine patients who received heart transplants at St. Luke's since the start of 2018, at least three have died, according to interviews with patients' family members, information provided by the hospital and data from the the United Network for Organ Sharing.

James "Lee" Lewis, a 52-year-old pipefitter from Bay City, Texas, received a transplant on Jan. 2, and he never recovered. Operating room equipment malfunctioned during a key stage of the surgery, and the donor heart failed.

Lewis died nearly three months later, on March 23, after undergoing more than a dozen operations and suffering numerous complications, including strokes, serious infections and organ failure. His wife, Jennifer, chronicled her husband's transplant and drawn-out death on Facebook and shared it with reporters for a story published last week.

"I'm glad they are doing something," Jennifer Lewis said upon learning of the program's suspension Friday. "That was my hope in speaking out and telling Lee's story."

Jennifer Lewis holds her husband, Lee's, urn in their home on Saturday, April 28, 2018, in Bay City.

Photo: Elizabeth Conley, Houston Chronicle

Another patient, a 67-year-old bankruptcy lawyer named Robert Barron, received a heart transplant on February 27, his son, Craig Barron, told a reporter this week. The transplant seemed to go well, Craig Barron said, but a couple of days later, the donor heart stopped twice, requiring emergency follow-up surgeries and leaving Robert Barron in critical condition.

Barron spent weeks connected to life-support machines and seemed to be recovering gradually, his son said. But then in April, Barron began to suffer from serious infections and other complications. A lack of blood flow to his father's intestines had left them "dead," Craig Barron recalled doctors saying. Later, physicians informed the family they would need to amputate his father's leg at the hip to try to prevent infection from spreading.

With no hope of recovery, the family made the decision to withdraw care on May 5, more than two months after the transplant. Four days after his father's funeral, Craig Barron was stunned to read the Chronicle and ProPublica story about problems in the program.

"It seemed like nobody could tell us what went wrong," Craig Barron said.

At least one other patient has died in recent weeks, hospital officials confirmed, though the person's identity was not released.

Prior to Friday, St. Luke's gave no indication of continued problems with the program. The day the Chronicle and ProPublica published their investigation, hospital CEO Gay Nord sent a message to employees: "We continue to express strong confidence in our internationally recognized heart-transplant program, despite this morning's media criticism that we believe ... in some cases is inaccurate, incomplete and does not represent our quality of care or our expertise in this specialized field of heart transplant," Nord wrote in the email, obtained by reporters. Neither Nord nor the hospital have contacted the news organizations seeking a correction.

St. Luke's also launched a website, HeartTransplantFacts.org, to counter the story's findings. On Friday, the site was replaced with a notice about the program's inactive status.

The decision punctuates a dramatic fall for one of the nation's most respected heart transplant programs. It was at St. Luke's that famed surgeon Denton Cooley performed some of the world's first heart transplants back in the 1960s, and where his protégé, Dr. O.H. "Bud" Frazier, has pursued a lifelong quest to develop a complete mechanical replacement for the human heart.

The hospital says it made changes when outcomes began to decline three years ago. After a string of transplant patient deaths in 2015, the program hired Morgan as its surgical director and became more conservative, removing some higher-risk patients from its waiting list. It is also more selective than its peers in its acceptance of donor hearts. Since then, program leaders said, the survival rate had improved.

But by at least some measures, the program continued to struggle.

In one of Morgan's first transplant surgeries at St. Luke's, in early 2016, he sewed shut one of two major veins that carry blood back to the heart, and the patient died a few weeks later, according to six medical professionals familiar with the case. Morgan declined to comment on the case, citing patient privacy.

In another patient's transplant a year later, Morgan stitched through the other major vein, according to the patient's cardiologist, though Morgan said the man's previous cancer treatments complicated the case. After the initial surgery, the blocked vein caused blood to pool in the patient's head, leading to an emergency repair, weeks of follow-up operations, a three-month hospital stay and ongoing health struggles, including kidney failure.

Some St. Luke's cardiologists grew so troubled by the program's direction in 2016 that they began referring some of their patients to other hospitals for transplants. One of those was Dr. Deborah Meyers, the medical director of the heart failure program at St. Luke's until early 2017, who said she raised concerns both before and after Morgan arrived, but believed she was ignored.

Last month, Meyers wrote a letter to Nord, the CEO, defending Frazier, who created the transplant program in 1982 and was the subject of another story by ProPublica and the Chronicle last week. In her letter, she was harshly critical of what the transplant program had become since CHI purchased the hospital in 2013.

"In my opinion, the shocking story of the Baylor St Luke's CHI transplant program is one of greed, careerism, corporate takeovers, appalling administrative oversight, failure of leadership, poor hiring practices, completely avoidable lawsuits, and the inevitable public distortions of their underlying mission, all of which have occurred as medicine has become perverted into 'big business,'" she wrote to Nord, indicating that she intended to share the letter with a ProPublica reporter.

Nord, in her reply, implored Meyers not to send the letter to the reporter.

Told Friday that the transplant program had been suspended, Meyers replied, "Finally, finally."

"The only ethical thing to do is stop the program right now," she said.

Across the country, other hospitals have suspended their heart transplant programs in order to make changes and then reopened them.

During the suspension at St. Luke's, officials said they will continue recruiting surgeons "to strengthen the program." A newly created special committee of the hospital's board of directors will also conduct a comprehensive review. The move will not affect other heart-failure procedures, such as heart-pump implants, or any other transplant programs across the hospital.

Judy Kveton said she was happy to learn St. Luke's was pausing to make changes. Her husband, David Kveton, died in February 2017 a week after receiving a heart transplant at St. Luke's. Two months later, she received an anonymous letter outlining problems at St. Luke's and indicating her husband didn't receive the care he deserved.

"I hope that they can clean up those problems within 14 days," Judy Kveton said of the program suspension. "However, I think they are so massive, it probably will take longer. It should take longer."

***

This story is the result of a collaboration between the Chronicle and ProPublica, an independent nonprofit newsroom based in New York. Mike Hixenbaugh is an investigative reporter at the Houston Chronicle. Charles Ornstein is a senior editor at ProPublica.

Mike Hixenbaugh is an investigative reporter focused on exposing fraud and abuse in health care. Previously, he was a reporter at The Virginian-Pilot in Norfolk, Va., where his work on the military and veterans affairs was co-published with ProPublica, NBC News and the Investigative Reporting Program at UC Berkeley. Mike graduated from the University of Akron in 2007, before going to work for small newspapers in Ohio and then North Carolina.